The Surgeon, continued...

Ann wished she could take the next day off too, but she knew that now that she had failed her board exam, there wasn’t any room for mistakes. She didn’t even have Joel helping her anymore. For some reason, he had seemed really upset after that woman left. She guessed he wasn’t going to want to be his advisor anymore.

I shouldn’t have come over to his apartment. That was so stupid.




But he had been the one who invited her. And she had wanted Joel to comfort her. She had wanted to feel his lips against hers. He was so difficult to resist. She had never been so attracted to a man before in her life.

When Joel arrived for rounds the next morning, she could see dark circles under his eyes. He looked as lousy as she felt. He wheeled up to the team and gave everyone a once over, “All right, what’s everyone waiting for? Let’s round.”

Joel was in rare form today. He ripped into Sheldon for not being able to name more than two antibiotics that were effective against pseudomonas. When Cody was presenting, he grilled her for five straight minutes about sarcoidosis. Ann could see Cody wavering and getting flustered. “This is medical student stuff, Cody,” he said to her. “You’ve got a patient with bilateral hilar adenopathy and you can’t answer a few basic questions about sarcoid? I’m very disappointed.”

His temperament just got worse after that. During one of their frequent elevator trips, they encountered a large family that was likely traveling upstairs to see a patient. There were about four small children, who were treating the elevator like a playground. “Move aside to let the man in the wheelchair come in,” the mother scolded the children.

Once they were inside, the children continued playing, oblivious to the new occupants of the elevator. One boy kept pushing his brother and the action was moving dangerously close to Joel’s wheelchair. Finally, just as the elevator doors opened, one of the boys knocked into Joel’s legs, sending his left leg into a strange angle and pushing his right leg entirely out of the footrest.

Joel quickly adjusted his legs using his arms, while Raj held the elevator door for him and all the kids stared. Joel’s face was red as he wheeled out of the elevator. He came out so quickly that his right leg went off kilter again and he had to fix it as soon as he was on the floor.

He was a little quieter after the elevator trip, but Ann didn’t hold out much hope for her own presentation. She got the feeling that Joel was saving up most of his wrath especially for her. Ann presented her patient to him, an anemic nursing home patient, and waited for the axe to fall. “What’s her hematocrit this morning?” he asked her.

“I… it wasn’t up in the computers yet when I checked,” Ann said.

“So your entire presentation was pointless then, wasn’t it?” Joel said. “You can’t even tell me the most important piece of information?”

Ann didn’t know what to say, so she kept quiet.

“If I were grading you, which I may have to do in the near future,” he went on, “I would say that presentation would be in the low average category. How long have you been on our service, Ann?”

“Almost a month,” she replied.

“I’d expect better,” he said simply. That one statement was more hurtful than anything he had ever said to her.

“Dr. Dergan, you’re ripping apart my whole team!” Raj broke in.

“Am I?” Joel asked innocently. Ann knew what he was doing was for her benefit. He was trying to make her cry again. But she wouldn’t give in. She was going to prove to him that she was stronger than she had been at the beginning of the year. “Well, in that case, I’m sorry,” he said. He glanced up at a clock on the wall. “Are we done?”

I did it! Ann thought as he wheeled away. I survived getting yelled at by Dr. Joel Dergan without crying!

Of course, in the scheme of things, what did her accomplishment mean? She had failed her board exam and lost a fantastic advisor all in one day.


Joel had a lot of work to do back in his office, but he couldn’t bring himself to do it. He felt awful. He had a headache and he felt “warm”, almost like he had a fever. He hadn’t slept well last night and it had taken its toll.

Joel looked down at his pants and noticed a dark spot. He immediately recognized it as urine. “Shit!” he said aloud. He had catheterized himself right before rounds, which was only two hours ago. He shouldn’t have been leaking. He wondered if the spot had been visible when he was with his team. Yet another thing for Cody and Ann to talk about during lunch—how their crippled attending wet his pants.

As he watched, the spot grew larger. He was going to have to get to the bathroom now and cath himself. Then he could look at his urine and see if it seemed like he was getting an infection. He wheeled out from behind his desk to look for something to cover his lap with until he reached the bathroom.

He heard a knock at the door and before he could say anything, Dr. Doug Howard, the medical student director, had entered his office. Howard had a stern look on his face, “Hi Joel, can I talk to you for a few minutes?”

Joel didn’t know what to say. He looked down and saw the damp area on his pants had spread across his entire crotch. Howard followed Joel’s gaze and his eyes widened, “Oh… I’m… I’m sorry, excuse me…” Howard stammered. He hesitated for a moment. “Uh… do you need any help?”

“No, I just need to go change,” Joel said tightly.

“Right, right…” Howard said. “Uh… would you come to my office after you’re done?”

“Fine.” Joel just wanted him to leave and end this humiliating moment.

After Howard was gone, Joel grabbed his spare pants and wheeled himself to the bathroom to change and cath himself. When he inserted the catheter, he felt no pain as usual, but the urine looked pretty cloudy. He probably needed to get a prescription for Cipro. He’d call one in later today.

As Joel pulled his soiled pants off his legs, he winced when he remembered how his legs had been knocked out of place in the elevator. That was one of the reasons he hated kids. He had been a spectacle when he was adjusting his legs as Raj held the door for him. He felt really crippled then.

He made it to Doug Howard’s office about ten minutes later, although he was still unable to look the man in the eye. Howard’s office was somewhat cramped and he had to jump up and move several chairs for Joel to be able to fit inside. “Thank you for coming, Joel,” Howard said. He was looking down at his desk as he spoke. “This is a very difficult conversation for me to have with you…”

Joel raised his eyebrows. This didn’t sound like the usual administrative bullshit. He suddenly remembered his conversation with Kyra last night. No, she didn’t… she wouldn’t…

“I got a very disturbing phone call today,” Howard began, “I was informed that… that you’ve been having an inappropriate relationship with one of the medical students, Ann Lowell.”

“I see,” Joel said. He felt very nauseated all of a sudden. For a moment, he was afraid he was going to be sick right there in the office, but the sensation passed.

“Of course, the thought is preposterous,” Howard continued, “I know you would never…”

“Right,” Joel said. The lie tasted bitter on his tongue. “I would never do that.”

“Still, this accusation reflects badly on everyone,” Howard said. “The protocol in this situation is to launch a thorough investigation, but in this case, I’m not sure it’s warranted…”

Joel suddenly realized what Howard was saying. Because Joel was a quadriplegic, they weren’t going to bother investigating him. They couldn’t conceive of him committing any kind of indiscretion with a student. How could a man who wets his pants have a relationship with a student?

“I trust you, Joel,” Howard finished his sentence. “I just wanted to make you aware of the accusation. Hopefully, it won’t go any further than this room.”

I got away with it, Joel realized. I can’t believe it.

Strangely enough, he didn’t feel good about it. He almost wished they had gone through with the investigation and uncovered the truth. He knew the right thing to do was to confess, but he couldn’t do it. He guessed his morals weren’t strong enough to risk his job. And Ann’s career too.

As he left Howard’s office, Joel felt a pain deep in his chest. He couldn’t believe Kyra had exposed him like that. He wouldn’t have believed it. After everything they had been through together, he couldn’t believe she would be so petty. Clearly, her residents were correct: she had become a coldhearted bitch.

When Joel returned to his office, he called Kyra on the private number she had left for him. He had been preparing to leave an angry answering machine message for her, so he was surprised when she picked up the phone. “Dr. Manning’s office.”

“Kyra? It’s Joel.”

“Joel…” Did her voice soften? She was probably feeling guilty. “About last night…”

“Good work trying to ruin me,” he said. “I honestly didn’t think you’d have the balls to go through with it.”

“I’m sorry,” she said. “I didn’t mean to say those things to you the other night. I just got angry because—”

“Cut the bullshit, Kyra,” he said. “Doug Howard already had a talk with me.”


She probably thought he didn’t know yet, that Howard wouldn’t have talked to him until they had gathered more information. “That’s right,” he said.

“Look, Joel, I told you, I’m sorry,” she said. “Look… I… I feel terrible about what I said.”

“It’s too late,” he said. He had more to say to her, but instead, he just slammed down the phone. She was the only woman he’d ever loved and she betrayed him six years ago and then again today. He didn’t want to speak to her again. He couldn’t.


Joel went home early that afternoon, popped a few ibuprofens, then went straight to bed. He had leaked in his pants again during the drive home, so he didn’t want to get out of the car to get his prescription at the local pharmacy. He figured one more day wouldn’t kill him. Tomorrow he’d wear an indwelling catheter in his penis to keep from something like this happening again.

However, the next morning, Joel woke up feeling infinitely worse. When he opened his eyes, his vision was blurred. His forehead and cheeks were on fire, yet he was shivering. He attempted to sit up, but immediately a wave of dizziness and nausea pushed him back down in bed.

He remembered how cloudy his urine had looked yesterday and he recognized that the infection had likely gotten out of hand. He cursed himself for not having taken care of it yesterday. Now he was going to wind up in the hospital for sure.

He doubted he was going to be able to make it to the emergency room on his own—he was probably going to have to call for an ambulance. He hated the idea of it. What were his neighbors going to think if he got wheeled out of here by paramedics with oxygen over his face? He didn’t even think the stretcher would be able to fit in the elevators.

The phone rang and Joel managed to pick the receiver up. To his surprise, he heard Kyra’s voice on the other line: “Joel? Listen, I want to talk to you.”

“Kyra…” The effort of even saying her name was draining.

“What’s wrong?” Kyra’s voice was immediately filled with concern.

“I’m… sick…” Until he said the words, he didn’t realize quite how sick he really was. “Can you… come over?”

“I’ll be there in five minutes,” Kyra said. He heard a click as she hung up the phone. Despite how angry he had been at her yesterday, he was glad Kyra had called—he had complete confidence that she’d make sure he got to a hospital. She was, after all, one of the smartest doctors he had ever met. He made a half-hearted attempt to place the phone back in the receiver, but instead it clattered to the floor. Even though he was lying down, he felt very dizzy and he could feel the sweat soaking through his undershirt.

I should have called for an ambulance, he thought, as he slipped into unconsciousness.

To be continued....